Thesis (M.S.)--University of Michigan, 1996. / Includes bibliographical references.

Thesis (D. Min.)--Southwestern Baptist Theological Seminary, 2008. / Abstract. Description based on Microfiche version record. Includes bibliographical references (leaves 168-200).

The general aim of this study was to determine the experiences of a sample of terminally ill patients in using spiritually focused psychotherapy. This was a qualitative study conducted to a sample of 2 terminally ill patients from hospice in Grahamstown, South Africa. The research was conducted in 3 phases: an initial in-depth interview conducted to determine the participants' level of spirituality as well as the extent to which their terminal illnesses had affected their functioning. This was followed by a minimum of 6 spiritually focused therapy (SFT) sessions as a second phase of the research. To determine the participants' experiences of SFT, 2-3 in-depth interviews were conducted during the 3m phase of the research study. The research revealed that a belief in a higher power helps terminally ill patients cope better with their illness and that social disconnectedness is related to HIV / AIDS stigma. It also revealed that terminal illness is co-morbid with other psychiatric symptoms such as depression, evokes existential concerns, results in a change in the level of spirituality and affects the whole family. Participants blamed themselves for their illness, but found that engaging in the process of forgiveness of self and others brought about psychological healing for them. They experienced SFT as a coping resource that assisted them to deal with the fear of death as well as increased insight into the development of psychopathology and spiritual blockages. It is recommended that a comprehensive and holistic assessment during intake be undertaken so that where spiritual needs are available, therapy can be spiritually augmented to ensure that such needs/ struggles are addressed. / KMBT_363 / Adobe Acrobat 9.54 Paper Capture Plug-in

Terminally ill patients and their families describe hospital care as nonsupportive to their needs during the final phase of life. Nurses generally are not comfortable with a supportive role when caring for the dying and tend to adhere to a curative role. The purpose of this descriptive, correlational study therefore was to describe the attitudes of general staff nurses working on medical-surgical units in hospitals towards the care of the dying and to ascertain the relationship between these attitudes and the education and experience of the nurses. An adaptation of the model for role episode, conflict, and ambiguity by Kahn, Wolfe, Quinn, Snoek and Rosenthal (1964) was the applied theoretical framework. The sample consisted of 197 randomly selected registered nurses employed full or part-time on general adult medical-surgical hospital units in British Columbia. The majority of the sample were married, Protestant females, between the ages of 26 and 45 years who were prepared at the diploma level in nursing. The mean length of time worked as a nurse was 8.5 years with a mean of 7.5 years on medical-surgical units. Attitudes towards the care of the dying were generally ambiguous, neither negative nor positive as measured by scores obtained on the ‘Questionnaire for Understanding the Dying Person and His Family’. Additionally, half the respondents did not believe that nurses should be the primary health care professionals equipped to deal with the emotional reactions of the dying yet three-quarters of the sample believed that patients turned to nurses to discuss such emotional issues. Data revealed that close to two-thirds of the respondents had received structured death and dying content in their basic nursing education yet less than half furthered their death and dying education since graduation. Overall death education for the sample was low. A small positive correlation (r=-0.26) was found between respondents' death education and their attitudes towards the care of the dying; no significant association was found between respondents' level of general nursing education and their attitudes. Although there was variability in the amount of professional and personal death experience, over half of the respondents experienced between one and three terminally ill patient deaths on their medical-surgical units per month. Additionally, the majority of respondents had experienced the death of an immediate family member. Overall death experience was low to moderate. A small, but significant positive correlation (r=0.24) was found between overall death experience and attitudes' towards the care of the dying; no significant association was found between general experience and attitude. Findings suggest that supportive nursing care is not being demonstrated with dying patients and their families. However, the influencing natures of death education and death experience on nurses' attitudes are positive, thereby providing the nursing profession with two possible ways of positively influencing nurses' attitudes to the care of the dying. / Applied Science, Faculty of / Nursing, School of / Graduate

The University Medical Center in Tucson, Arizona developed and implemented a procedure-specific Limitation of Medical Care (LMC) form on December 1, 1989 to address medical futility and lack of clarity in do-not-attempt-resuscitation (DNAR) orders. A retrospective review of two years of data, with 300 usable responses, showed an increased amount of participation by patients and their surrogates in the DNAR decision with the LMC form. Use of the form was also associated with an increased number of medical interventions specified to be withheld after a DNAR or LMC order was written. There was no decrease in expenditures or length of survival associated with use of the form, nor was there a decrease in the number of codes called for patients who had an order that resuscitation was not to be attempted. An average $13,347 of charges were accrued in the ICU for patients in the pre-form group, $4,314 on average being after a DNAR order was written. An average $21,957 of charges were accrued in the ICU for patients in the post-form group, $8,733 on average being after a DNAR order was written. An average $20,523 of total charges were accrued for patients in the pre-form group, $7,156 on average being after a DNAR order was written. An average $29,830 of total charges were accrued in the ICU for patients in the post-form group, $12,550 on average being after a DNAR order was written. Recommendations for the UMC Bioethics Committee and future research suggestions are presented.

Law, Wai Yan. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2010. / Includes bibliographical references (leaves 83-92). / Abstracts in English and Chinese. / ABSTRACT --- p.I / 論文摘要 --- p.II / TABLE OF CONTENTS --- p.III / Chapter CHAPTER 1 --- INTRODUCTION --- p.1 / Chapter CHAPTER 2 --- LISA SOWLE CAHILL´ةS THEOLOGICAL BACKGROUND --- p.5 / Chapter 2.1 --- Introduction --- p.5 / Chapter 2.2 --- Cahill´ةs theological approach to Christian Ethics --- p.5 / Chapter 2.2.1 --- Catholicism --- p.6 / Chapter 2.2.2 --- Feminism --- p.9 / Chapter 2.2.3 --- Theological Anthropology --- p.16 / Chapter 2.3 --- Moral Methodology --- p.21 / Chapter 2.3.1 --- The Bible --- p.21 / Chapter 2.3.2 --- Tradition --- p.22 / Chapter 2.3.3 --- Normative Accounts of the Human --- p.24 / Chapter 2.3.4 --- Descriptive Accounts of the Human --- p.25 / Chapter 2.4 --- Conclusion --- p.26 / Chapter CHAPTER 3 --- LISA SOWLE CAHILL´ةS PARTICIPATORY THEOLOGICAL BIOETHICS --- p.28 / Chapter 3.1 --- Introduction --- p.28 / Chapter 3.2 --- Cahill´ةs Participatory Theological Bioethics --- p.28 / Chapter 3.2.1 --- Principle of Analysis --- p.29 / Chapter 3.2.1.1 --- Ordinary and Extraordinary means of life support --- p.30 / Chapter 3.2.1.2 --- Principle of double effect --- p.31 / Chapter 3.2.2 --- The common good and bioethics --- p.34 / Chapter 3.2.3 --- Theological bioethics and Social Transformation --- p.38 / Chapter 3.2.4 --- Summary --- p.40 / Chapter 3.3 --- Evaluation and Dialogue with Cahill´ةs Participatory Theological Bioethics --- p.41 / Chapter 3.3.1 --- Catholicism --- p.41 / Chapter 3.3.2 --- Feminism --- p.42 / Chapter 3.3.3 --- Common Good --- p.44 / Chapter 3.4 --- Conclusion --- p.46 / Chapter CHAPTER 4 --- END-OF-LIFE CARE IN HONG KONG --- p.47 / Chapter 4.1 --- Introduction --- p.47 / Chapter 4.2 --- End-of-life care in Hong Kong --- p.48 / Chapter 4.2.1 --- Decline and dying in Hong Kong --- p.48 / Chapter 4.2.2 --- Ethical judgments by the health care professions --- p.50 / Chapter 4.2.3 --- Advance directive --- p.54 / Chapter 4.2.4 --- Patients or family´ةs participation --- p.54 / Chapter 4.2.5 --- Chinese culture and Bioethics --- p.56 / Chapter 4.3 --- Christianity engagement in the end-of-life care in Hong Kong --- p.59 / Chapter 4.3.1 --- Christian communities --- p.59 / Chapter 4.3.2 --- Theology bioethics --- p.60 / Chapter 4.4 --- Conclusion --- p.61 / Chapter CHAPTER 5 --- PARTICIPATORY THEOLOGICAL BIOETHICS IN HONG KONG --- p.63 / Chapter 5.1 --- Introduction --- p.63 / Chapter 5.2 --- The significance and relevance of Participatory Theological Bioethics --- p.63 / Chapter 5.2.1 --- Both individual and social ethics --- p.64 / Chapter 5.2.1.1 --- Who is/are the poor? --- p.64 / Chapter 5.2.1.2 --- Inequalities in access to end-of-life care --- p.66 / Chapter 5.2.1.3 --- Medical paternalism --- p.71 / Chapter 5.2.2 --- Transcendent meanings of life --- p.73 / Chapter 5.3 --- INTERCULTURAL DIALOGUE OF PARTICIPATORY THEOLOGICAL BIOETHICS --- p.74 / Chapter 5.3.1 --- Familial relationship as a starting point --- p.75 / Chapter 5.3.2 --- Interpretation of ´بParticipatory´ة --- p.76 / Chapter 5.4 --- Conclusion --- p.80 / Chapter CHAPTER 6 --- CONCLUSION --- p.81 / BIBLIOGRAPHY --- p.83

No description available.

Background: Losing an infant is difficult for parents to face. To improve EOL care for dying neonates and their families, NICU nurses need to overcome obstacles and implement supportive behaviors. Understanding the size of obstacles and supportive behaviors will better enable NICU nurses to provide quality EOL care. Objectives: To determine the largest obstacles and supportive behaviors in NICU EOL care. Methods: A descriptive quantitative study of a random national sample of 1058 NICU nurses who were members of NANN (National Association of Neonatal Nurses). The National Survey of NICU Nurses' Perceptions of End-of-Life Care questionnaire was mailed twice yielding 234 usable questionnaires for a response rate of 26%. Results: Three themes emerged in the top rated obstacles: (a) obstacles related to families, (b) obstacles regarding language and communication, and (c) obstacles concerning ethical dilemmas. The lowest rated obstacles were nurses believing that life-saving measures/treatments were prematurely discontinued and unit visiting hours being too liberal. The top eight supportive behaviors included helping families cope with the infant's death and those involving helpful physician behaviors. Lowest rated supportive behaviors were those related to the nurses' own family death experience and behaviors promoting nurse convenience. Conclusions: Obstacles and supportive behaviors for NICU EOL care have been identified. Issues regarding families, communication, and ethical dilemmas need to be addressed. Efforts should be made to more quickly align the plan of care with the projected outcome to limit both infant suffering and nurse distress from inappropriate use of life-extending measures.

This phenomenological study describes the experiences of twelve registered nurses who have nursed a dying or dead patient. These registered nurses come from a variety of backgrounds, not only personally, but also educationally and socially. The study primarily focuses on these registered nurses' most significant experience with death in a professional capacity. Twelve registered nurses were invited to share their stories by means of taped interviews and/or written narrative which attempted to discover the underlying meaning of their experiences. However, in relating their stories, many of the registered nurses wished to describe other death experiences which were of significance for them. The study is grounded in Heideggerian phenomenology and analysis of the transcripts revealed the emerging essences of connectedness, aloneness, questioning and accepting. The study further reveals that these essences align themselves to the four fundamental existentials of spatiality, corporeality, temporality and relationality as described by Merleau-Ponty (1962). Additionally, these essences are related back to the principles of Parse's (1987) theory of Human-Becoming and provide some insights for nursing practice when caring for the dying or the dead patient. Some discussion on how these insights may be related to contemporary nursing practice in Australia is highlighted. Each participant's transcript is followed by a poem which intends to capture the essence of their relationship with the situation(s) they have shared with the author. / Master of Science (Hons) (Social Ecology)

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